The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

Gemma C Sharp; Abigail Fraser; Gemma Sawyer; Gabriella Kountourides; Kayleigh E Easey; Gemma Ford; Zuzanna Olszewska; Laura D Howe; Deborah A Lawlor; Alexandra Alvergne; Jacqueline A Maybin

doi:10.1093/ije/dyab239

Menstrual Cycle · Cycle Disorders

The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

Sharp GC, Fraser A, Sawyer G, Kountourides G, Easey KE, Ford G, Olszewska Z, Howe LD, Lawlor DA, Alvergne A, Maybin JA

Published June 13, 2022 International journal of epidemiology, 51(3), 691-700

DOI 10.1093/ije/dyab239 PMID 34865021 PMC PMC8690231

RRM Academy Synopsis

Menstrual cycle changes during COVID-19 lack strong evidence

The review searched world research through August 2021. It found just 12 small studies on menstrual cycles during the pandemic, many based on self-reported, self-selected samples. Among the 12 studies, none made full use of doctors' standard tools to define a normal cycle. The authors call for larger, more rigorous studies.

Key Findings

The review identified 12 small studies through 31 August 2021. Nine covered cycle changes during the pandemic period, and 3 covered changes tied to COVID-19 illness itself.
Only 1 of the 12 studies used a validated questionnaire, the Premenstrual Symptoms Screening Tool. None made full use of the FIGO standardized measures for cycle frequency, duration, regularity, or volume.
A study of 30,000 Japanese women linked HPV vaccination to higher rates of hospital visits for abnormal bleeding (OR 1.43, 95% CI 1.13-1.82) and irregular periods (OR 1.29, 95% CI 1.12-1.49).
As of early September 2021, more than 30,000 reports of menstrual changes after COVID-19 vaccination had reached the UK's yellow card scheme. The review's search found no formal studies of the link.
Nine of the 12 studies came from low- or middle-income countries. Four of the 12 either stratified by hormonal contraceptive use or excluded users from their sample.

Interpretation

The paper is a narrative literature review. It is not a study of patients. The authors searched PubMed, Scopus, and preprint servers under a pre-registered protocol. The existing science is thin. The review's search found only 12 small studies, many based on self-reported, self-selected samples. None made full use of an agreed way of measuring a menstrual cycle. The gap makes it hard to tell true change from normal variation, or to separate effects of pandemic stress, infection, treatments, and vaccines. The review cannot show that COVID-19 or its vaccines cause cycle changes. The review maps what is unknown and sets a research agenda, including a call for standardized measurement and an international research network.

RRM Context

The paper treats the menstrual cycle as a vital sign. The framing matches how NaProTechnology and other fertility awareness-based methods use daily cycle charting to track hormonal health. The paper also suggests that existing cycle-tracking apps could supply some of the missing long-term data. It flags real limits, though, noting that app users are a self-selected group and app data have a lot of missing entries.

Our editorial summary of this paper, not the article's abstract.

Abstract not indexed.

Topics

Menstrual Cycle › Cycle Disorders › Abnormal Uterine Bleeding · Research Methods › Evidence Synthesis › Systematic Reviews

Gemma C Sharp, Abigail Fraser, Gemma Sawyer, Gabriella Kountourides, Kayleigh E Easey, Gemma Ford, Zuzanna Olszewska, Laura D Howe, Deborah A Lawlor, Alexandra Alvergne, Jacqueline A Maybin

G Sharp, Abby Fraser, A Fraser, G Sawyer, G Kountourides, K Easey, G Ford, Z Olszewska, L Howe, Debbie Lawlor, Deb Lawlor, D Lawlor, Alex Alvergne, A Alvergne, J Maybin

PMID 34865021 34865021 DOI 10.1093/ije/dyab239 10.1093/ije/dyab239 Sharp et al. 2022, Sharp 2022

The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

Menstrual cycle changes during COVID-19 lack strong evidence

Key Findings

Interpretation

RRM Context

Topics

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